MEDICARE: ELAN WELTER LEWIS EDD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	PC003940	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1952358	OTHER	PA	HIGHMARK PROVIDER NUMBER

General Provider Information

NPI Number	:	1023212883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELAN WELTER LEWIS EDD

Provider Business Mailing Address
First Line	:	100 BRUGH AVE
Second Line	:
City	:	BUTLER
State	:	PA
Zip	:	16001-6410
Country	:	US
Telephone Number	:	724-284-9440
Fax Number	:	724-284-9441

Provider Business Practice Location Address
First Line	:	100 BRUGH AVE
Second Line	:
City	:	BUTLER
State	:	PA
Zip	:	16001-6410
Country	:	US
Telephone Number	:	724-284-9440
Fax Number	:	724-284-9441

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2007
Last Update Date	:	07/08/2007

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